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丝裂原活化蛋白激酶(MAPK)信号通路靶向疗法:晚期黑色素瘤患者特殊毒性的护理与管理

MAPK Pathway-Targeted Therapies: Care and Management of Unique Toxicities in Patients With Advanced Melanoma
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作者信息

Rubin Krista M

机构信息

Massachusetts General Hospital Cancer Center.

出版信息

Clin J Oncol Nurs. 2017 Dec 1;21(6):699-709. doi: 10.1188/17.CJON.699-709.

Abstract

BACKGROUND: Agents targeting the MAPK pathway, including inhibitors of BRAF and MEK, have dramatically transformed the treatment landscape for patients with BRAF-mutant metastatic melanoma. Although generally well tolerated, targeted agents were associated with unique toxicities.
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OBJECTIVES: This article aims to provide nurses with an overview of the key toxicities and associated management strategies of the characteristic adverse event (AE) profile associated with agents targeting the MAPK pathway.
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METHODS: Data from clinical trials evaluating vemurafenib, dabrafenib, trametinib, and cobimetinib were reviewed and summarized along with research on management of AEs identified in clinical trials.
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FINDINGS

The key AEs associated with these agents included pyrexia and cutaneous toxicities. Other notable AEs included arthralgias, ocular toxicities, and cardiac events. Because these agents are administered until progressive disease or unacceptable toxicity, nurses should be aware of management strategies to optimize treatment outcomes.

摘要

背景

包括BRAF和MEK抑制剂在内的靶向丝裂原活化蛋白激酶(MAPK)通路的药物,极大地改变了BRAF突变转移性黑色素瘤患者的治疗格局。尽管这些靶向药物总体耐受性良好,但也存在独特的毒性。

目的

本文旨在向护士概述与靶向MAPK通路药物相关的关键毒性以及特征性不良事件(AE)谱的相关管理策略。

方法

回顾并总结了评估维莫非尼、达拉非尼、曲美替尼和考比替尼的临床试验数据,以及对临床试验中确定的不良事件管理的研究。

结果

与这些药物相关的关键不良事件包括发热和皮肤毒性。其他值得注意的不良事件包括关节痛、眼部毒性和心脏事件。由于这些药物一直使用到疾病进展或出现不可接受的毒性,护士应了解优化治疗结果的管理策略。

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